ALBANY – House Republicans’ long-awaited plan to replace the Affordable Care Act led New York officials Tuesday to assess its impact on the state and its residents as Congress grapples with the bill’s chances of passage.

The system that provides home care for New York’s ailing, elderly and disabled populations is in crisis due primarily to economic pressures, including a state reimbursement formula that has pushed some rural care providers to the brink of not being able to make payroll.

That was the message conveyed by dozens of witnesses who attended a Capitol hearing Monday called by the Assembly committees on health, aging, labor and health. The Legislature returns to Albany on Tuesday to begin the final month of negotiation of the budget.

The potential repeal of the Affordable Care Act and the uncertainty over what might replace it have state lawmakers warning of a major budget hole in New York – and wondering how to remedy it.

At City & State’s State of New York Finance event on Tuesday, a panel of lawmakers and industry officials had more questions than solutions for how the state will prepare for and respond to a full repeal of the health care law, widely known as Obamacare.

On Wednesday, February 22, the Assembly Committees on Health, Aging, Labor, and Task Force on People with Disabilities will hold a public hearing in New York City on the crisis of New York’s inadequate home care workforce.

Home care allows individuals to receive health care and personal services to live at home instead of in a nursing home or other facility. There is a growing shortage of home care services for the elderly, people with disabilities, and people who are chronically ill. Advocates note that there is a shortage of home care workers that is causing waitlists for these services across the state at a time when demand is increasing. Inadequate Medicaid funding for home care may be a significant obstacle to hiring and keeping people in the home care workforce.

The hearing will focus on obstacles to recruiting, employing, and retaining a sufficient workforce. Witnesses are expected to include patient advocacy groups and self-advocates, home care and disability service providers, and home care workers and organized labor groups.

Drug price controls, the adequacy of Medicaid payments and expanding the power of the Health Department were among the topics discussed at a legislative hearing Thursday on Gov. Andrew Cuomo’s proposed budget for health and Medicaid.

An underlying theme was uncertainty about what action President Donald Trump and a Republican-led Congress might take on the Affordable Care Act, which could affect health insurance subsidies for New Yorkers, and funding for women’s reproductive health clinics, including Planned Parenthood.

“Much is happening in Washington,” state Health Commissioner Howard Zucker told lawmakers. “If the ACA were repealed, that would be a major concern, with millions of people potentially losing health care.”

The longtime chairman of the Assembly Health Committee on Wednesday released a lengthy essay on the potential impacts on health-care policy by the incoming Donald Trump presidential administration.

Those concerns raised by Assemblyman Dick Gottfried, a Manhattan Democrat, range from the new federal administration gutting medical marijuana laws on the state level, scaling back benefits for Medicaid recipients and the repeal of the Affordable Care Act, which could blow a $2 billion hole in the state budget.

“The first step in stopping or reversing these attacks is to clearly understand what’s at stake and spread the word,” Gottfried wrote in the statement released by his office. “There is hardly anything more rigged against working people than health care. The Trump-Republican agenda will make it worse.

Gottfried’s solution to bolster health care in New York under Trump is his long-stalled proposal for universal coverage in New York through a single-payer system.

“Instead of regressive premiums, deductibles, co-pays and out-of-network charges, it would be funded fairly through broad-based taxes based on ability to pay,” Gottfried wrote. “The Assembly passed the bill in 2015 and 2016 – helping to move it from being “a great idea that could never happen” to something really achievable. In 2017, we will continue to work to build public support so it can ultimately pass the Senate.”

The election of Donald Trump and Republican control of Congress are a serious threat to programs and policies that protect our health. Washington could make radical changes to Medicare, Medicaid, the Affordable Care Act, reproductive care, and other programs that could drastically undermine our right to health care, cost New York State billions of dollars a year in federal funds, and destabilize health care providers.

The first step in stopping or reversing these attacks is to clearly understand what’s at stake and spread the word. There is hardly anything more rigged against working people than health care. The Trump-Republican agenda will make it worse. This is a time to redouble efforts in more progressive states like New York to create universal access to health care, with funding based fairly on ability to pay, through an “improved Medicare for all” system.

For years, congressional attacks on funding and programs have been defeated by the threat or use of presidential vetoes. Now we will have a president who may be leading the charge.

ALBANY — President-elect Donald Trump’s pledge to repeal and replace the Affordable Care Act could have steep fiscal implications for New York, which has 3.3 million people enrolled in its health exchange.

Since New York’s health exchange launched under so-called Obamacare in 2013, Medicaid recipients rapidly increased as millions of low-income New Yorkers signed up for health care.

The federal government subsidized much of the cost, and last year New York launched a new program, the Essential Plan — an off-shoot of Medicaid that in part provides coverage to immigrants otherwise ineligible — that has seen its enrollment soar.

The state Budget Division estimated that the federal subsidies for the Essential Plan alone this year would exceed $1 billion, which could be wiped out under Trump’s proposals.

WELCOME!

I represent Chelsea, Hell’s Kitchen, Midtown, and parts of Murray Hill and the Lincoln Center area in the State Assembly. I have been chair of the Assembly Health Committee since 1987. During off hours, I like to write Chinese calligraphy.